PRADHANAKARMA

Vamana (Emesis Terapy)
Vamana is considered best for the elimination of morbid and increased Kapha, and thus for curing the disorders of Kapha. It eliminates the Doṣa through stomach by vomiting and should generally be given after performing Snehana and Svedana.
The patient should be given full meal on the previous day. On the day of performing the Vamana, the patient should be given some Abhiṣyandi diet in the morning, and thence administered Vamana drug. Thereafter patient should be given either sugarcane juice or decoction of Yaṣṭimadhu (glycyrrhiza) or salt water to start the emesis. The dose of these drugs depends on the quantum of Doṣa, the time of emesis and also on the symptoms of proper Vamana (Samyak Yoga). The ideal drug is Madanaphala which may be given in 25 g. to 50 g. dose with honey.

Indications of Vamana
Cold (Pīnasa), skin diseases (Kuṣṭha), recent fever, cough (Kāsa), breathlessness (Śvāsa), diseases of throat, enlargement of thyroid (Galagaṇḍa), elephantiasis (Ślīpada), urinary disorders (Prameha), diminished digestive power (Mandāgni), indigestion, acute and chronic poisoning (Viṣa), bleeding from lower part of the body (Adhoga-Rakta-Pitta), piles, nausea, anorexia (Aruci), scrofula, epilepsy (Apasmāra), insanity (Unmāda), diarrhea (Atisāra), oedama (Śopha), anaemia (Pāṇḍu), stomatitis, Stanya-Doṣa and disorders of Kapha are the conditions where Vamana therapy is indicated.

Contraindications of Vamana
The Vamana therapy is contraindicated in very obese, extremely emaciated, infants, senile, debilitated, fatigued, thirsty, hungry and exhausted patients. It is also contraindicated in those who have undergone fasting, Nirūha and AnuvāsanaBasti, excessive sexual intercourse and exercise, pregnant women and delicate persons. Vamana should not be performed in the conditions like bleeding from upper parts of body, vomiting, Udāvarta, cardiac disorders (Hṛdroga), lesions of urinary tract, splenic disorders, Gulma, prostatic enlargement (Aṣṭhīla), fainting, headache, pain in the ear and eye etc.

Criteria for proper Vamana
The signs of SamyakVamana are that the patient first passes Kapha followed by pitta, the chest, throat and head become free of congestion and the body becomes light. In Ayoga of Vamana, the patient either does not vomit or vomits only the drug taken. In Atiyoga of Vamana the patient passes blood with vomiting.
After proper vomiting, the patient may wash his hands, face, feet and then he may be given rest for one hour. Thereafter he should be given Dhūmrapāna and be removed to the bed. This should be followed by the SaṁsarjanaKrama.

Virecana (Purgation Therapy)
After the patient has been given Vamana he should once more be given Snehana and Svedana. Afterwards, on an auspicious day he should be given Trivṛt (turpeth root bark) in the dose of 10 to 15 g. with a suitable liquid.

Indications of Virecana
Virecana is indicated in skin diseases (Kuṣṭha), fever, urinary disorders (Prameha), bleeding from upper part (UrdhvagaRaktapitta), fistula in ano, abdominal disorders, piles, inauinal swelling, splenic disorders, Arbuda, goitre (Galagaṇḍa), Visarpa, acute pain in the sides (Pārśva-śūla), headache (ŚirahŚūla) Udāvarta, flatulence, burning in eyes and mouth, cardiac disorders (Hṛdroga), moles, excessive discharge from mouth, eyes and nose, anaemia (Pāṇḍu), Halīmaka, breathlessness (Śvāsa), cough (Kāsa), scrofula (Apacī), epilepsy (Apasmāra), insanity (Unmāda), gout (Vātarakta), gynaecological disorders (Yonidoṣa), Śukradoṣa, faintings, anorexia, indigestion, vomiting, oedema, leucorrhoea (Pradara) and disorders of Pitta.

Contraindications of Virecana
Virecana should not be performed in the persons with delicate constitution (SukumāraPrakṛti), pregnancy, those suffering from ulceration or prolapse of rectum, bleeding from lower part of the body (AdhogaRaktapitta), continued fasting (Laṅghana), weakness of sensory organs, diminished digestive power (Alpāgni), those who have taken NirūhaBasti, suffering from recent fever, alcoholism, distension of abdomen (Ādhmāna), foreign body, injury (Kṣata), Ati-Snigdha, Atirūkṣa, Krūra-Koṣṭha and pregnancy etc.

Criteria for proper Virecana
Provocation of Doṣa, exhaustion, diminished digestive power, heaviness of body, cold, torpor, anorexia are the signs and symptoms of Ayoga of Virecana.
Passing of faeces, bile, mucus and flatus in succession with the motions along with the feeling of purification of the channels (Srotas), clearing of senses, lightness of body, increase in digestive power, a sense of well-being are the signs and symptoms of proper (Samyak) Virecana.
Numbness, bodyache, exhaustion, tremors and the symptoms which are produced due to loss of Kapha, blood and Pitta, loss of vitality, fainting, mental disturbance, loss of sleep and hiccough are the signs and symptoms of Atiyoga of Virecana.
When the patient has shown the symptoms of Samyak (proper) Virecana, he should be given SaṁsarjanaKrama and on the ninth day ghee or AnuvāsanaBasti may be given.

Basti (Enema Therapy)
The medicine given through enema is called Basti. It is the best treatment for the elimination of morbid Vāta. This therapy may also be used for the promotion of the health as it provides happiness, long life, strength, digestive power, intelligence, voice and colour. It is free from risks, hence it can be administered at all ages. It draws out unwanted faeces, mucus, bile, flatus and urine, imparts firmness, enriches semen and gives body strength.
Basti is of two types viz. NirūhaBasti and AnuvāsanaBasti. The Basti in which the preparation containing fat is given is called AnuvāsanaBasti and in which only decoction of the drug is given through Basti is known as Nirūha (Āsthāpana) Basti.
Three days after giving ghee as mentioned in Virecana Karma, the patient should be given oil massage and thereafter he may be given NirūhaBasti. Care should be taken that after purgation, NirūhaBasti should not be given before 7 days. In the same way Virecana should also not be given with in 7 days of performing NirūhaBasti.

Indications of NirūhaBasti
NirūhaBasti is indicated in all the 80 disorders of Vāta, paralysis (SarvāngaVāta), abdominal disorders (KukṣiRoga), retention of flatus, faeces, urine and semen, loss of vitality (Balakṣaya), morbid complexion (Varṇakṣaya), emaciation (Māṁsakṣaya), flatulence (Ādhmāna), numbness (Aṅgasupti), worms (Kṛmi), Gulma, Udāvarta, pain and swelling of joints (Parvabheda), feeling of intense heat (Abhitāpa), diseases of spleen and heart, fistula in ano, insanity (Unmāda), fever, inguinal swelling, headache, earache; pain in the bones, buttocks, knee joints, thighs, ankles, feet, hands, fingers, teeth and nails; rigidity in the sides, back and lumbar region; tremors (Kampa), convulsions (Ākṣepa), heaviness in the body (Gaurava), debility (Śoṣa), spasm (Stambha), noises in the intestines, cutting pain in the abdomen, evacuation of small quantity of very faeces with noise.

Contraindications of NirūhaBasti
NirūhaBasti is contraindicated in conditions of indigestion (Ajīrṇa), Atisnigdha (over dose of Sneha), Mandāgni, exhaustion, weakness, hunger, thirst, excessive emaciation, just after meal, immediately after emesis, purgation or Śirovirecana; in conditions of anger, fright, intoxication, fainting, breathlessness, cough, hiccough (Hikkā), intestinal obstruction or perforation, ascites, Ādhmāna, Alasaka, Visūcikā, miscarriage, diarrhoea (Āmātisāra), diabetes (Madhumeha) and skin diseases.

Indications of AnuvāsanaBasti
AnuvāsanaBasti is indicated in the conditions where NirūhaBasti may be given particularly in persons who are Rūkṣa, having excessive digestive power (Tīkṣṇāgni) and disorders of Vāta.

Contraindications of AnuvāsanaBasti
In addition to the contraindications mentioned in NirūhaBasti, the AnuvāsanaBasti is also contraindicated in persons who have not taken any food, suffering from recent fevers anaemia, jaundice, urinary disorders (Prameha), piles, coryza (Pratiśyāya), anorexia (Aruci), weak digestive power (Mandāgni), debility, (Daurbalya), splenic disorders, abdominal disorders due to Kapha, Ūrustambha, loose stools, ingestion of poisons, discharge of mucus or bile, hard bowel conditions, elephantiasis (Ślīpada), goitre (Galagaṇḍa), scrofula (Apacī) and intestinal worms (UdaraKṛmi).

Order of Basti
After the enema when the fluid of NirūhaBasti has returned, the patient should be given food during the day and also in the evening. Thereafter he should be given Anuvāsana on the second, third or fifth day. After giving NirūhaBasti on every third or fifth day, he should again be given AnuvāsanaBasti.
In disorders of Kapha one or three Basti should be given; in disorders of Pitta, five or seven; and in disorders of Vāta, nine or even eleven Basti should be given.

Effects of Basti
When body-channels have been cleaned by Nirūha, Sneha (oleation) given by AnuvāsanaBasti imparts colour and strength. Oil by its unctuous quality, counteracts dryness, by its heaviness, counteracts lightness and by its heat (Ūṣma) quality it counteracts coldness (Śaitya) of Vāta. Thus it quickly imparts clarity of mind, virility, strength and colour and increases gastric juices.

Criteria for proper NirūhaBasti
Proper elimination of faeces, urine and flatus; increase of appetite and improvement of digestion (Agnivṛddhi), feeling of lightness in lower abdomen (Pakvāśaya), alleviation of symptoms of ailment, restoration of health and vitality are the signs and symptoms of proper (Samyak) NirūhaBasti.
Headache, pain in the heart region, stomach and rectum, oedema, coryza, cutting pain, nausea, retention of flatus and urine, and breathlessness (Śvāsa) are the signs of under action (Ayoga) of NirūhaBasti. Signs described for Atiyoga of Virecana are also the signs of Ati-Yoga of NirūhaBasti.

Criteria for proper AnuvāsanaBasti
Return of enema fluid with faeces without retention, purification of Rakta, Dhātu, intellect and sensory organs, inclination to sleep, feeling of well-being, increase of vitality and regulation of excretory urges are the signs and symptoms of proper performing of AnuvāsanaBasti.
Pain in lower part of body, abdomen, arms, back and sides of the body, dryness and roughness of limbs, obstruction of faeces, urine and flatus are the signs and symptoms of under action (Ayoga) of AnuvāsanaBasti.
Nausea, stupor, exhaustion, fainting, cutting pain in rectum are the signs and symptoms of over action (Atiyoga) of AnuvāsanaBasti.

Śirovirecana
Śirovirecana (Nasya) is the procedure of giving medicine through the nose. After the body has been purified, the persons’ head should be methodically anointed (Sneha-massage) and then fomented by palm of the hand. Thereafter Śirovirecana may be given according to the degree of intensity of Doṣa.

Indications of Śirovirecana
Śirovirecana is specially indicated in Śiroroga, stiffness of neck, throat spasm, lock jaw, HanuGraha, coryza (Pīnasa), tonsillitis, KaṇṭhaŚālūka, Timira, glossitis, hemicrania, disease of neck, shoulders, mouth, ear, nose, eye, cranium and forehead; facial paralysis, convulsions, rigidity (Stambha), Galagaṇḍa, toothache, looseness of teeth, eye-infection, Arbuda, alteration of voice, loss of voice, speech etc., and diseases of supra clavicular region.

Contraindications of Śirovirecana
Śirovirecana is not to be given in cloudy days. Peoples who have been given Virecana or AnuvāsanaBasti should not be given Nasya. Persons who are suffering from indigestion, who have just taken meals of Sneha, thirsty, those who have bathed their head, afflicted with hunger, fatigued or intoxicated, fainted, injured or exhausted by sex act, exercise and pregnancy, and suffering from coryza, recent fever should not be given Śirovirecana.

Criteria for proper Śirovirecana
Lightness of head and chest, clarity of senses and purification of body channels (Srotas) are the signs of proper administration (Samyak Yoga) of Śirovirecana. Mucus secretion in the throat, heaviness of head and ptylism are the signs of under action (Ayoga) of Śirovirecana. Aching pain in the head, eyes, temples and ear and faintness are the signs of over action (Atiyoga) of Śirovirecana.

Nasya (Medication through nose)
Medication through nose is worthy of mention as this method has been found to be very effective. The expert physician should administer Dravya for Bṛṁhaṇa, Śodhana and Śamana through nose for the well being of the organs or cure of the diseases of ear, nose, throat and the brain (Urdhajatru-GataVyādhi). Śodhana is recommended in stiffness, numbness, heaviness and similar symptoms appearing in the Urdhajatru due to Kapha. Tarpaṇa is specially suitable for soothing in diseases like Śiraskampa, Ardita and other diseases due to Vāta. ŚamanaNasya is useful in bleeding etc.

Methods of Nasya
They are five viz. (i) inunction (Nāvana), (ii) instillation of nasal drops (Avapīḍana), (iii) insufflation (Dhmāpana), (iv) inhalation (Dhūmra) and (v) topical application (Pratimarśa).
Nāvana has two actions viz. oleation and purification. Avapīḍana has also two actions viz. purification and astringent action. Dhmāpana brings about purification. Dhūmrapāna brings about Śamana and Pratimarśa brings about Snehana

  • PUBLISHED DATE : May 06, 2015
  • PUBLISHED BY : NHP CC DC
  • CREATED / VALIDATED BY : NHP Admin
  • LAST UPDATED ON : May 06, 2015

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